Idea 8: Increasing R&D How can we leverage existing federal and grant funds to grow research and development, especially in technology that reduces cost and improves quality, as well as expand metro Detroit’s life science sector? Marianne Udow-Phillips, Director Center for Healthcare Research & Transformation

Michigan Health Care Expenditures Source: CHRT Calculations based on National Health Expenditure Projections, CMS Office of the Actuary

Michigan Opportunity Affordable Care Act $5 million for the design, implementation, and evaluation of models in FY2010 $10 billion for Center for Medicare and Medicaid Innovation-initiated activities, FY2010-2019 and each decade after Patient Centered Outcomes Research Institute funded at $10 million in FY2010 and expect to grow to $500 million by FY2013 U-M North Campus Research Complex. During fiscal year 2009, U-M spent $1.01 billion on research and development, the highest spending public university

Spending on Backs, U.S. & MI, 2007 An Example of What Can Be Done Hospital spending on back disorders alone: $26 billion in the U.S. $819 million in Michigan Spinal fusion was the 3rd costliest procedure in both the U.S. and Michigan $26 billion in U.S. $836 million in MI BCBSM spending on diagnostic radiology $763 million dollars in 2006 72 percent of PGIP imaging was high tech imaging Source: CHRT issue brief: Cost Burden of Disease, January 2010

Geographic Variation in CT Scans An Example of What Can Be Done State average: 1.01/1,000 adult BCBSM members Highest hospital referral regions (HRRs) Marquette 2.27 Petoskey 1.47 Saginaw 1.43 Lowest HRRs Muskegon 0.79 Ann Arbor 0.73 Lansing 0.64 Source: CHRTBook: Health Care Variation in Michigan, 2010

Geographic Variation in Back Surgery An Example of What Can Be Done State average: 1.78/1,000 adult BCBSM members Highest HRRs Petoskey 2.58 Saginaw 2.46 Marquette 2.40 Lowest HRRs Detroit 1.49 Ann Arbor 1.33 St. Joseph 1.23 Source: CHRTBook: Health Care Variation in Michigan, 2010

Community Spine Project An Example of What Can Be Done The Need Expensive imaging for back pain is unnecessary but often used The Experiment Use an interactive video game called “Back Quack” and community marketing to educate patients about their back pain and appropriate tests, and to help physicians with language to use when talking about back pain. Overall Goal Reduce MRIs and CT Scans in a community through innovative education of patients and physicians. Projected over the next several years (an update to our 1st issue brief including projectio